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Mortality of a lithium-treated population.
The British Journal of Psychiatry : the Journal of Mental Science
|September 1, 1984
Summary
Lithium treatment in South-East Scotland showed a 36-fold increase in suicide deaths and a 2.15-fold increase in cardiovascular disease mortality. No increased deaths from cancer, leukemia, or nephropathy were observed.
Area of Science:
- Pharmacovigilance
- Epidemiology
- Psychiatric drug safety
Background:
- Lithium is a widely used mood stabilizer for bipolar disorder.
- Long-term safety data, particularly regarding mortality, requires ongoing investigation.
Purpose of the Study:
- To assess the long-term mortality risks associated with lithium treatment.
- To identify specific causes of excess mortality in patients receiving lithium therapy.
Main Methods:
- A cohort of 791 patients treated with lithium for over two months in South-East Scotland (1967-1976) was identified.
- Mortality data was collected using public and health service records.
- A case-control analysis compared deceased patients with matched survivors.
Main Results:
- The standardized mortality ratio was 2.83.
- Excess mortality was significantly linked to suicide (36-fold increase) and cardiovascular disease (2.15-fold increase).
- No significant increase in deaths from nephropathy, cancer, or leukemia was found.
Conclusions:
- Lithium treatment is associated with significantly increased mortality from suicide and cardiovascular disease.
- Patients who died on lithium exhibited more physical health issues at treatment initiation compared to survivors.
- These findings highlight the need for careful patient monitoring and risk assessment during lithium therapy.